Health and Human Services Secretary Alex Azar and the Trump administration are proposing new regulations for short-term health insurance plans, focusing on value-based care as a priority. According to reports, Azar’s speech focused on value-based care, an approach in which doctors and hospitals are reimbursed by private health insurance and the government for how well patients emerge after a medical procedure versus the amount of care provided.

The proposed rule — which would allow people to be covered by a short-term, limited duration health plan for 364 days is garnering a negative response from some states which plan to reject the proposed rule. These states can also ban the rule altogether. The Short-term plans are inexpensive compared to plans sold on the state and federal insurance exchanges since they will not be subject to Obamacare’s premium-inflating mandates.

Reports indicate that the proposed rule could have major effects on state marketplaces if enough healthy consumers opt for short-term plans instead of the plans offered under the 2010 health care law. For Buyers who opt-in, they would pay lower premiums, but as a consequence of risking their health by having less coverage than they expect when a medical issue occurs. According to new sources: The administration estimates that between 100,000 and 200,000 Americans will abandon their marketplace coverage for a short-term plan in 2019.